Provider Demographics
NPI:1134508666
Name:1ST ALLIANCE SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:1ST ALLIANCE SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LIEFINA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-995-6754
Mailing Address - Street 1:860 JOHNSON FERRY RD
Mailing Address - Street 2:SUITE # 140-145
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1435
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:860 JOHNSON FERRY RD
Practice Address - Street 2:SUITE # 140-145
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1435
Practice Address - Country:US
Practice Address - Phone:404-995-6754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical AssistantGroup - Multi-Specialty